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Washington, DC rates for HCPCS Q4111

GammaGraft, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $7.08 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $13.18
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $18.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.41 / $7.94 / $7.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $8.32
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.30 / $141.25 / $169.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $7.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $12.88 / $125.89